Wellness: Concepts and Applications 8 th Edition Anspaugh, Hamrick, Rosato Preventing Cardiovascular Disease Chapter 2
Cardiovascular Disease the leading cause of death in the U.S. 35.3% of all deaths Approximately 25% of Americans have one or more forms of heart or blood vessel disease. Approximately 80,000,000 people Approximately 445,687 people die annually of coronary heart disease (CHD).
The Heart Consists of cardiac muscle Weighs 8 to 10 ounces Has two halves (pumps) Divided by the septum Halves are divided into upper chambers (atria) and lower chambers (ventricles)
Circulation The primary function of circulation is to provide a constant supply of blood and nutrients to cells while removing their waste products The left side of the heart (systemic pump) receives the oxygenated blood from the lungs and pumps it to all the tissues in the body The right side of the heart (pulmonary pump) receives deoxygenated blood from the body and pumps it to the lungs
Circulation The heart has its own conduction system The beating rate and rhythm are established by the sinoatrial (SA) node (pacemaker) The electrical contraction pauses at the atrioventricular (AV) node, allowing the ventricles to fill with blood
Circulation The heart is supplied with blood from coronary circulation after it has been ejected from the heart Blood is so important to the heart that every muscle fiber is supplied by at least one capillary
Cardiovascular Disease Cardiovascular disease rare 100 years ago Reached epidemic proportions during the middle 20 century Coronary heart disease (coronary artery disease; CAD) is diagnosed when any artery is narrowed by 60% or more A myocardial infarction (heart attack; death of the heart muscle) occurs when blood flow to the heart muscle is disrupted Most heart attacks occur after age 65, but the problems leading up to them begin as early as adolescence
Myocardial Infarction The medical term for heart attack is myocardial infarction (MI) Up to one third of all heart attacks are silent without obvious signs or symptoms Silent ischemia, reduced blood flow, can initiate heart attacks without warning
Cardiovascular Disease (2) Americans as young as 8 have obstructions in their coronary arteries caused by atherosclerosis Slow progressive inflammatory disease of the arteries characterized by the deposition of plaque beneath the lining of the artery
Stroke (Brain Attack) Strokes are caused by: a thrombus, an embolus (70% to 80%), a cerebral hemorrhage Brain cells die, causing loss of function of some parts of the body Strokes have similar risk and prevention factors as heart disease Full blown strokes may be preceded by transient ischemic attack (TIA) mini strokes Produce stroke-like symptoms, temporary, and usually no lasting damage People who have one or more TIA more likely to suffer stroke
Unchangeable Risk Factors for Heart Disease Age 55% of heart attacks occur after age 65 Male gender Heart disease is the leading cause of death for both males and females Females have a lower rate than males Rate is increasing among females, particularly those who smoke and use oral contraceptives Heredity & Race 1) Family history of cardiovascular disease 2) African Americans have high incidence of hypertension 3) Mexican Americans, Native Americans, Nativre Hawiaiians & some Asians Americans have high rate of CVD because of obesity
Major Risk Factors That Can Be Changed Cholesterol is a steroid that does not dissolve in blood, so it is transported to cells by protein packages A certain amount of cholesterol is necessary for good health The best way to lower serum (blood) cholesterol is to reduce intake of saturated fat Saturated fat increases the liver s production of cholesterol
Major Risk Factors That Can Be Changed Low-density lipoproteins (LDL), the primary transporters of cholesterol, are the most capable of producing atherosclerosis People with low blood levels of LDL (less than 100 mg/dl) rarely have heart attacks Cigarette smoke, lack of exercise, hypertension, high cholesterol, excessive weight, unhealthy diet, and rapid heart rate result in continued inflammation and growth of plaque High density lipoproteins (HDL) are invoved in reverse transport of cholesterol transfer to liver Cholesterol removed from the blood helping to prevent and reduce plaque
Blood Pressure (1) Blood pressure is the force exerted against artery walls as blood travels through the circulatory system Recorded in millimeters of mercury (mmhg) High blood pressure (hypertension) has no signs or symptoms An estimated 90% to 95% of hypertension is essential (of unknown origin) Approximately 73,600,000 American adults have hypertension Prehypertension includes blood pressures ranging from 120/80 to 139/89 Estimated that 56,600,000 Hypertension= 140/90 mmhg
Blood Pressure (2) Long-term uncontrolled hypertension increases the work of the heart, causes it to hypertrophy, and leads to congestive heart failure Hypertension is the most important risk factor for strokes Treatment include some or all of the following: Weight loss Salt and alcohol restriction Adequate intake of calcium, potassium, & magnesium Relaxation Techniques Exercise medications
Cigarette Smoking/Tobacco Use Cigarette smoking is considered to be the most harmful of the preventable risk factors for chronic illness and premature death These illnesses include chronic bronchitis, emphysema, strokes, and 87% of all lung cancers Loss of life from smoking represents a life expectancy drop of ~18% Passive smoking, inhaling the smoke of others, causes the deaths of 38,000 to 43,000 nonsmokers annually
Cigarette Smoking/Tobacco Use (2) Harmful products in cigarettes Nicotine Carbon monoxide Poisonous gases, tars, chemical additives Harmful effects of smoking are insidious and take time to appear Quitting is vital Smoking increases the risks for many chronic diseases Smoking encourages the accumulation of visceral fat (abdominal fat) Visceral fat leads to a constellation of risk factors call the metabolic syndrome or insulin-resistance syndrome
Physical Inactivity Physical inactivity increases the risk of coronary heart disease by 1.5 to 2.4 times The greatest health benefits are gained when people expend 1500 to 2000 calories (walk 15 to 20 miles) per week Exercise for health does not have to be as strenuous as exercise for physical fitness But physical fitness is an important factor in cardiovascular health
Physical Inactivity Physical activity is any physical movement that results in energy expenditure walking, mowing the lawn, vacuuming Sedentary death syndrome (SeDS) created to illustrate the burgeoning lists of health disorders that are exacerbated by a lack of physical activity Relates to 23 diseases Elevated blood fats, Type II diabetes, hypertension, heart disease, obesity, osteoporosis, resting tachycardia, etc. Every U.S. adult should accumulate 30 minutes or more of moderate intensity physical activity on most, preferably all, days of the week. (ACSM/CDC statement)
Obesity Obese people who have no other risk factors are still more likely to develop heart disease or stroke. Fat that accumulates in the upper half of the body (central abdominal obesity) is significantly more likely to contribute to heart disease A 5% to 10% weight loss that is maintained can significantly reduce the risk of heart disease Obesity among children and teenagers has been increasing the last few decades
Diabetes Mellitus Diabetes is a metabolic disorder in which the body cannot properly use sugar (glucose) as fuel Type II (90% of all diabetes) typically occurs in older, overweight, sedentary adults It is being seen more and more in children, adolescents, and young adults Diabetes increases the risk of coronary artery disease 2 to 4 times that of non-diabetics
Changeable Risk Factors Stress Stress elevates heart rate, blood pressure, breathing rate, and blood sugar levels, activates the immune response, and causes other physiological changes Chronic (long-term) distress significantly strains the body
Preventable / Changeable Risk Factors: Cholesterol Blood Pressure Cigarette Smoking/Tobacco Use Physical Inactivity Obesity Diabetes Mellitus Stress
Homocysteine Lipoprotein (a) Other Risk Factors High-Sensitivity C-Reactive Protein (hs-crp) Elevated fibrinogen level Peripheral artery disease (PAD) Metabolic Syndrome Collection of risk factors that increase risk for CVD and stroke
Preventing and Reversing Heart Disease Preventing includes: Exercising regularly Maintaining an optimal body weight Practicing sound nutrition Nonuse of tobacco and other drugs Nonuse or moderate use of alcohol Dealing constructively with stress Periodic medical examinations
Preventing and Reversing Heart Reversing includes: Disease Following a low-fat diet Stopping tobacco use Managing stress Attending support group meetings regularly Exercising consistently at a moderately intense level
Other Risk Factors Other factors include: Iron-enriched blood Homocysteine Lipoprotein High Sensitivity C-Reactive Protein Fibrinogin
Diagnostic Techniques Medical examination and patient history Exercise stress tests Thallium treadmill test Echocardiography Cardiac catheterization
Medical Treatment Low-dose aspirin therapy Coronary artery bypass surgery Balloon angioplasty Coronary stent Artificial valves Left ventricular assist devices Heart transplants